| 12/21/2011 |
| 07:21:58 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| FOUNTAIN, SUE, | 4X-004012 | R | 24.95 | 5141********1158 | 946205 | 12/21/11 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 24.95 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 24.95 |